If we are ever to know with any certainty that crisis lines are effective in reducing deaths from suicide, or in managing distress levels in individuals before they are suicidal, three essential questions must be addressed: 1. Of the entire population of potential callers to a crisis line, what are the characteristics of individuals who cll a crisis line? 2. What are the key behavioral characteristics of responders that moderate individual characteristics of callers, resulting in acceptance of a referral given from a responder to the caller? 3. Is there an impact on important outcomes: death from suicide, suicide attempts and reattempts, hospitalization for suicidal behaviors, engagement in an ongoing safety planning process, and overall reductions in psycho-social distress?